Myth Debunked: Most Providers Accept New Medicare Patients

A new study seems to blow a hole in the myth that many primary care physicians won’t accept new Medicare patients because the reimbursements are notoriously low.

In fact, most office-based doctors accept both new Medicare and privately insured patients, according to the study by the Kaiser Family Foundation. That’s despite the fact that group health and individual health insurers pay more for services than Medicare does, the foundation said in a brief.

The results from this study should allay concerns that Medicare recipients, particularly those who are new to Medicare, have about being able to continue seeing their regular doctor. While some people may have trouble, the majority do not, according to the study.

Here are the main findings of the KFF study:

  • 89% of office-based physicians were accepting Medicare patients in 2019, while 91% of them were accepting privately insured patients.
  • The share of office-based doctors accepting new Medicare patients stayed virtually the same in the past decade, with the percentage at 88% in 2011.
  • Nearly 20% of general or family practice and internal medicine physicians were not accepting new Medicare patients or new privately insured patients in 2018.
  • 87% of medical specialists and 96% of surgical specialists were accepting new Medicare patients. In fact, among the 12 most common specialties, the results were the same. However, obstetricians and gynecologists were the most likely to accept new patients with private insurance (99%) than Medicare patients (93%).
  • The worst for accepting new patients were psychiatrists, with only 59% accepting new Medicare patients and 60% accepting new privately insured patients. The rates that psychiatrists and psychologists charge people who pay in cash are much higher than they can get from insurance.
  • Medicare beneficiaries and privately insured individuals also had equal access to physicians in both rural and urban areas, the KFF brief noted.
  • 1% of physicians opted out of Medicare in 2022.

The takeaway

While you may be concerned as you enter the Medicare system that you will no longer be able to see your current personal physician, your fears may be displaced. Although there is a percentage of Medicare enrollees who lose access to their doctors, many do not.

You can work with me to find the best solution for your circumstances.

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